Hey guys,

had the video visit with Mayo MN yesterday.

Here is recap of my Numbers: Gleason: 3+4 , 1/12 CORES POS. small lesion 1MM. 30% 4. No Cribriform, No intraductal.
MRI: pretty clean, not much diffusion. PI-RADS 2.
Decipher : .80
Prostate size: 34 cc
PSA holding pretty steady around 2.0 to 2.3 for last two years.
Health: good, very fit.
Visit with Mayo surgeon, thought I was scheduled with the Focal Dr. My mistake. (lots of appointments these days, getting hard to juggle). So, a little bit of a waste but Mayo is a class operation. Dr. was good communicator. I did not get a lot of Focal Info. I have a new appointment at Mayo with Focal Dr. Not until Sept.
I did get some info off the Mayo surgeon though. He had done 1700 RARP total. 2/week lately. ( I think he is probably pretty skilled. I have experienced surgeons near me in Chicago also)
This what he said:
If you are healthy and have solid baseline urinary cont. and erection scores at surgery the RP Numbers are as follows :
BCR: at 5 years 1-2% (sounds low)
Erections: (w/wo help (no pumps but pills or needle) 70% prob. after 1year
Continence: 90% after 1 year.

I didn't ask about Focal too much. He did say my high decipher means I should give a little more weight to surgery option. Also: if BRCA-2 (?) gene is present you should probably NOT do active surveillance.
So, I am still thinking about Focal of course. Big HIFU Dr. in Chicago says 25% non-recurrence with HIFU.
webinar by Dr Klotz (famous in Urol.) you Tube. " Is Focal Th. right for your Prostate Cancer" 8/31/2023. very informative. Talked about results for HIFU and Tulsa and Cryo. Minute 39:00 talks about o Visible vs. Invisible Tumors and MSLK NY study. Metastatic outcomes down the road ( ? years) higher in 'VISIBLE 'tumors than INVISIBLE tumors!!!!! (on the surface , that makes sense, larger, visible tumors are probably going to Metastasize over time, but, it does give some insight on the small invisible ones we all fear so much. So, unseen tumors are not as threatening as believed. he said: 'it really turned some Dr.'s heads around on Focal strategies'. Also his thoughts on the similarities of treatment timelines between breast cancer and prostate cancer. (early in the video?) watch video yourself to form your own opinion.

I would like to say to all those who have more serious situations than myself, hang in there, we are all thinking of you, and rooting for you. things get better every day.